Why the study?
Complex coronary artery lesions increase procedural complexity and are associated with worse cardiovascular outcomes and higher ischemic risk, warranting a review of evidence for their percutaneous management.
This review summarizes current evidence for the percutaneous management of complex coronary lesions, including chronic total occlusions, graft interventions, in-stent restenosis, and antithrombotic strategies.
May guide complex PCI planning; leaves open need for dedicated RCTs on techniques and antithrombotics.
Clinicians have long recognized that certain features of coronary artery lesions increase the complexity of intervention. Complex lesions are associated with worse cardiovascular outcomes and a higher risk of subsequent ischemic events. These lesions are categorized by their angiographic features. These features include bifurcation lesions, left main coronary artery disease, calcified lesions, in-stent restenosis, chronic total occlusions and graft interventions. This two-part review aims to highlight the current evidence in the percutaneous management of these lesions. Part two of this review focuses on the indications to treat chronic total occlusions, interventions of failed grafts, tools used to treat in-stent restenosis, as well as antithrombotic strategies.
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Feldman et al. (2022) studied this question.
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